The resignation of renowned breast cancer specialist surgeon Professor Carol-Ann Benn from the Helen Joseph Hospital has fuelled concerns about the loss of expertise for the public health sector amid existing pressures on cancer services in Gauteng, writes Ufrieda Ho for Spotlight.
Concerns have also been raised about what some labelled an unconducive workplace culture and worsening working conditions at the hospital.
Some hospital insiders called the environment toxic with patriarchy and petty hierarchies. This, compounded with ongoing operational challenges, is having a dire impact on staff retention and the quality of patient care.
Benn’s last day at the clinic at the end of September brought to a close a 17-year-long relationship with the public health facility.
Volunteers from the not-for-profit Breast Health Foundation of which Benn is a founding director have backed her decision and have also ended their services at the hospital.
“The Breast Health Foundation’s decision to withdraw services in solidarity with Professor Benn comes after months of trying to address barriers to the provision of quality patient care and a lack of support from senior management,” its statement read.
Louise Turner, chief operations officer at the foundation, says after an initial phone conversation there have been no further discussions on a resolution to restart their services there. The foundation had five patient navigators and three volunteers at Helen Joseph Hospital (HJH). Navigators guide patients through their journey from diagnosis to treatment, help to link them to services, and to advance them along long cancer treatment waiting lists. They also offer psycho-social counselling and become a practical support net.
‘It is only one employee who has resigned’
The Gauteng Department of Health, however, says no patients will be affected negatively by the resignation of Benn and the foundation and that the clinic remains fully operational.
Spokesperson Kgomotso Mophulane, says: “The Breast Clinic is not closed at Helen Joseph Hospital. It is only one employee who has resigned but the clinic continues to have other specialists running the clinic.”
Mophulane says that the Breast Health Foundation does not have a formal agreement with the Health Department and that “existing agreements with other facilities like Charlotte Maxeke Johannesburg Academic Hospital (CMJAH) continue”.
If the shoe doesn’t fit
Benn has straddled public and private healthcare throughout her 30-year career and remains head of the Netcare Breast Care Centre and lecturer at Wits University’s department of surgery.
“Leaving Helen Joseph after 17 years has been a struggle,” she says. “There was harassment and an obstructive workplace culture that made our daily working lives impossible, but I can’t spend my time getting into trouble for trying to find solutions. And if my patients have to face so much to survive, then I can survive this too.”
Benn says she’s “stepping outside to find solutions”. She says her next focus is to find ways to reform access for cancer treatment on lower-level medical aid schemes without massive co-payments and her work in the public sector continues. She is managing her existing Helen Joseph patients at her Milpark Hospital practice and says she’s had positive advances to establish a “patient-centred unit for equitable care for public patients within the private sector” within the next few weeks.
A long history
Turner says the Breast Health Foundation has helped turn the clinic into a hub of excellence. “So much of what is in the clinic we raised money for – from painting the walls, décor, to the chairs and furniture in the counselling rooms.”
They’ve helped around 200 000 patients to be “navigated” through the maze of cancer diagnosis and treatment at the facility and around 10 000 people who were diagnosed with cancers were supported through their journey of cancer treatment.
But she says it was clear the workplace environment had become increasingly untenable for Benn and the Foundation’s team. She says Benn was constantly summoned to meetings to justify her decisions and was criticised and undermined for veering off administrative procedures.
“Her approach has always been about putting the patient first. She has used her own money to buy surgical drains or surgical gloves so that she could do her work. She always made a plan, including squeezing in surgeries and she accepted patients who do not fall into the Helen Joseph catchment area because of their need to access services. But senior management would make her life hell over this,” she says.
‘A family of survivors’
Patient navigator for the Breast Health Foundation Ouma Mamatela was a patient of Benn in 2016 before she joined the Foundation.
She says patients at HJH are now paying the price for “egos and mismanagement”.
“It’s going to be very hard for patients who expect to find the navigators there to hold their hand through everything. We built up a family of survivors. I am still waking up very early on Tuesdays and Thursdays because those were the days I knew I was getting up to serve our patients at Helen Joseph,” she says.
She adds that Benn’s out-of-the-box thinking, accessibility to patients, and transparency in how she worked irked senior male managers and doctors.
“She is one person who speaks to everyone. She doesn’t make herself untouchable. Those managers need to put their egos aside because it is the patients who need quality care the most who are suffering.”
Dozens of Helen Joseph patients have since weighed in via social media in support of Benn and the Foundation, sharing their stories and also their deepening worries about what comes next for their treatment.
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